110 research outputs found
Karakteristik Pasien Cedera Tulang Belakang di Rumah Sakit Haji Adam Malik Medan
No full textBackground. Spinal injury is a dislocation or fracture caused by trauma. Spinal injuries can result in the loss of motor function, sensation, reflex functions, and others. These injuries can occur due to traffic accidents, workplace accidents, or various other conditions that lead to trauma. Objective. To determine the frequency distribution and characteristics of spinal injury patients at Haji Adam Malik Hospital in Medan. Method. The research was conducted using descriptive methods and a cross-sectional study approach, with a sample size of 62 individuals obtained from medical records using consecutive sampling techniques. Results. The most common results were found in males (72.6%) with an age range of 46-55 years (21%). The most frequent education level of the respondents was no formal education (43.5%). The majority of respondents underwent non-operative therapy, with the total of 41 individuals (66.1%). The most common neurological condition was Frankel A, with 25 individuals (40.3%), and the most common injury region was thoracic, with 26 individuals (41.9%). The majority of injuries occurred due to traumatic mechanisms, with the total of 62 individuals (100%). Conclusion. The highest incidence of spinal injuries is found in males in the early elderly age group with no formal education. The majority also did not undergo operative therapy, suffered from Frankel A neurological conditions, and occurred in the thoracic region.58 PagesSkripsi Sarjan
Ulnar Nerve Status in Patients After Open Reduction and Internal Fixation of Distal Humerus Fractures at Adam Malik General Hospital Medan
No full textBackground: Distal humerus fractures are complex injuries that often require open reduction with internal fixation (ORIF). One common complication is ulnar nerve injury, which has been reported to be related to the surgical approach. This study aimed to analyze the relationship between the type of surgical approach and the incidence of ulnar nerve injury after ORIF in distal humerus fractures. Methods: This observational, analytical, cross-sectional study was conducted on 45 patients who underwent distal humerus ORIF at Adam Malik General Hospital, Medan, between 2020 and 2024. Data were collected from medical records and postoperative neurological examinations using the McGowan classification. The surgical approaches studied were: paratricipital, triceps splitting, and Chevron osteotomy. Results: The mean age of the patients was 42.02±12.46 years, with the majority being male (60%). The most common mechanism of injury was falls (46.67%). The paratricipital approach was most frequently used (44.44%), followed by Chevron osteotomy (35.56%) and triceps splitting (20%). Postoperative ulnar nerve injury was found in 3 patients (6.67%), with the highest incidence proportionally in the triceps splitting approach (11.1%). Kolmogorov-Smirnov analysis showed a non-significant association between surgical approach and ulnar nerve injury (p = 0.786). Conclusion: No significant association was found between the ORIF surgical approach and the incidence of ulnar nerve injury. This finding can be used as a consideration in selecting a safe surgical approach to the ulnar nerve in distal humerus fractures.59 PagesTesis Magiste
Effectiveness of Intra-Articular Injection of Platelet Rich Plasma on Arthrogenic Contracture of Knee Joint in Rats
No full textIntroduction: Platelet-rich plasma (PRP) is a biological treatment for several musculoskeletal
disorders. Currently, the application of PRP in cases of arthrogenic contracture has not been well
investigated. This research seeks to evaluate the efficacy of intra-articular platelet-rich plasma
injections for treating arthrogenic contracture of the knee joint in a rat model.
Methods: The study involved 24 Wistar rats categorized into three groups: a control group, a group
receiving an intra-articular injection of 0.9% NaCl, and a group receiving an intra-articular
injection of PRP. All rat groups will experience knee joint immobilization. Range of motion
measurements, morphometric analysis of the capsule, and cell quantification from the joint capsule
were performed. We use ANOVA test or Kruskal-Wallis test for statistical analysis.
Results: The PRP group exhibited a PROM both pre- and post-myotomy that was significantly
superior to that of the control and 0.9% NaCl groups, with p-values of 0.002 and <0.001,
respectively. The average cell count in the PRP group significantly differs from that in the control
and 0.9% NaCl groups (p=0.005). The PRP group has a greater capsule length and a reduced
average capsule thickness in comparison to the other two groups, with statistical significance at
p<0.001 and p=0.001, respectively.
Conclusion: The administration of intra-articular injections of platelet-rich plasma in the knees of
rats with arthrogenic contracture led to an increased range of joint motion, a reduced inflammatory
cell count, elongated of the capsule and a reduction in its thickness.64 PagesTesis Magiste
Effectiveness of Intra-Articular Injection of Platelet Rich Plasma on Arthrogenic Contracture of Knee Joint in Rats
No full textIntroduction: Platelet-rich plasma (PRP) is a biological treatment for several musculoskeletal
disorders. Currently, the application of PRP in cases of arthrogenic contracture has not been well
investigated. This research seeks to evaluate the efficacy of intra-articular platelet-rich plasma
injections for treating arthrogenic contracture of the knee joint in a rat model.
Methods: The study involved 24 Wistar rats categorized into three groups: a control group, a group
receiving an intra-articular injection of 0.9% NaCl, and a group receiving an intra-articular
injection of PRP. All rat groups will experience knee joint immobilization. Range of motion
measurements, morphometric analysis of the capsule, and cell quantification from the joint capsule
were performed. We use ANOVA test or Kruskal-Wallis test for statistical analysis.
Results: The PRP group exhibited a PROM both pre- and post-myotomy that was significantly
superior to that of the control and 0.9% NaCl groups, with p-values of 0.002 and <0.001,
respectively. The average cell count in the PRP group significantly differs from that in the control
and 0.9% NaCl groups (p=0.005). The PRP group has a greater capsule length and a reduced
average capsule thickness in comparison to the other two groups, with statistical significance at
p<0.001 and p=0.001, respectively.
Conclusion: The administration of intra-articular injections of platelet-rich plasma in the knees of
rats with arthrogenic contracture led to an increased range of joint motion, a reduced inflammatory
cell count, elongated of the capsule and a reduction in its thickness.64 PagesTesis Magiste
Characteristics of Patients Undergoing Anterior Cruciate Ligament Surgery at Adam Malik General Hospital and Network Hospital of Department of Orthopaedic and Traumatology on 2017 - 2022
No full textACL injury is the most common injury of all knee injuries, with surgery still being the definitive treatment of ACL rupture. And it Contributes to one of the highest number of knee surgery. It is important that every factor and characteristic that might influence the surgical process and
outcome are identified.
Methods This study was conducted with 118 patients, which underwent ACL reconstruction surgery.
Patients underwent surgery at least 9 months before data collection. The patients’ data was collected from several teaching hospitals. Informed consent was created beforehand.
Result
The subject of this study consists of 99 men and 19 female. Surgery was mainly done in the chronic phase of injury, 74 patients with 44 patients underwent surgery in the acute phase.
ACL tears caused by contact injuries are more common, 89 people (75.4%) compared to noncontact injuries, 29 people (24%). 77 patients (65.3%) who had total tears and 41 people (34.7%) with partial tears. Hamstring tendon graft were used in 92 patients (78%), with the quadriceps tendon in 22 patients (18.6%), and the peroneus longus tendon in 4 people (3.4%).
Tears are more commonly found in patient with high school level of education 65 patients (55.1%).
Discussion Most of the patients with ACL rupture at Adam Malik General Hospital were caused by contact injuries. ACL ruptures are associated with the severity of work and it is consistent with this study which shows that patients with heavy work are more prone to experiencing ACL tears.
Many ACL rupture sufferers was only high school graduates which can be caused directly by
the low education, or because the high school population usually are more active
Conclusion
This study presents new data for the ACL rupture characteristics in Medan, a metropolitan city
in a middle income country. The data shows similar findings with data gathered from other
populations.69 PagesTesis Magiste
Studi pemikiran Raden Haji Muhammad Nuh Cianjur tentang penentuan arah kiblat dalam kitab Risalah al-Qiblah
No full textPerkembangan ilmu pengetahuan dan teknologi pada saat ini memang sangat memungkinkan untuk menemukan arah kiblat yang lebih akurat. Risalah al-Qiblah karya Raden Haji Muhammad Nuh Cianjur merupakan kitab yang membahas mengenai penentuan arah kiblat yang dilengkapi data nilai arah kiblat terhadap Barat dan Utara untuk 18 Kota di Indonesia dan arah kiblat untuk 278 kota diseluruh dunia (Asia, Afrika, Eropa, dan Australia).
Melihat permasalahan di atas, penulis ingin menganalisis akurasi arah kiblat dalam kitab tersebut dengan teori dan perhitungan yang sama dan modern. Sehingga penulis merumuskan dua masalah dalam penelitian ini, yaitu bagaimana pemikiran Raden Haji Muhammad Nuh dalam penentuan arah kiblat? dan bagaimana tingkat akurasi arah kiblat dalam kitab Risalah al-Qiblah karya Radsen Haji Muhammad Nuh Cianjur?
Metode yang digunakan penulis dalam penelitian ini adalah metode kualitatif, dengan data primer yaitu Kitab Risalah al-Qiblah dan wawancara dengan peneliti sebelumnya. Sedangkan data skundernya penulis mengambil dari buku-buku dan karya ilmiah yang berhunungan dengan arah kiblat. mengenai analisis data penulis menggunakan metode deskiptif analitik yaitu analisis dengan menggambarkan perhitungan arah kiblat dengan teori yang ada.
Hasil penelitian menunjukkan bahwa setelah penulis melakukan observasi, ternyata ditemukan hasil arah kiblat dari kitab Risalah al-Qiblah selisih 2˚ dengan teori perhitungan segitiga bola. Artinya arah kiblat dalam kitab Risalah al-Qiblah bisa dikatakan akurat bila memakai teori segitiga bola karena masih dalam konteks Ihtiyatul Kakbah.
ABSTRACT:
The development of science and technology at this time is indeed very possible to find a more accurate Qibla direction. The Risale al-Qiblah by Raden Haji Muhammad Nuh Cianjur is a book that discusses the determination of the Qibla direction which is equipped with data on the Qibla direction values to the West and North for 18 Cities in Indonesia and the Qibla direction for 278 cities around the world (Asia, Africa, Europe and Australia ).
Seeing the problems above, the author wants to analyze the accuracy of the Qibla direction in the book with the same and modern theories and calculations. So the authors formulate two problems in this study, namely how Raden Haji Muhammad Nuh's thoughts in determining the Qibla direction? and what is the level of accuracy of Qibla direction in the book Risale al-Qiblah by Radsen Haji Muhammad Nuh Cianjur?
The method used by the author in this study is a qualitative method, with primary data, namely the Book of Risale al-Qiblah and interviews with previous researchers. While the secondary data the author takes from books and scientific works related to the Qibla direction. regarding data analysis the author uses descriptive analytic method, namely analysis by describing the calculation of Qibla direction with existing theory.
The results showed that after the writer made observations, it was found that the results of the Qibla direction from the Risale al-Qiblah book had a difference of 2˚ with the spherical triangle calculation theory. This means that the Qibla direction in the Risale al-Qiblah book can be said to be accurate when using the spherical triangle theory because it is still in the context of the Ihtiyatul Kaaba
Gambaran Kasus Osteoartritis Lutut di RSUP Haji Adam Malik Medan Tahun 2020-2021
No full textBackground. Osteoarthritis is a degenerative joint disease that affects the articular
cartilage, subchondral, bone, synovium, and joint capsule through the
pathophysiology of various factors. Cartilage degeneration is the main
pathological finding of osteoarthritis. Aim. This study aims to describe cases of
knee osteoarthritis at Haji Adam Malik Hospital in Medan in 2020-2021. Methods.
This research is a descriptive study with a cross-sectional design. This study used
the total sampling method by taking all members of the population as a sample.
Subjects in this study were knee osteoarthritis patients at RSUP. H. Adam Malik
Medan in 2020-2021. The data used is secondary data obtained from the patient's
medical records. The data analysis used is descriptive statistics. Results. This study
involved 83 patients with knee osteoarthritis consisting of 23 (27.7%) men and 60
(72.3%) women, with patients over the age of 45 years as many as 77 people
(92.8%). There were 42 people (50.6%) not working, 61 people (73.5%) did not
have a history of trauma, 32 people (38.6%) with BMI 25-29.9, 25 people (30.1%)
were included to grade 4 classification, 43 people (51.8%) had complaints before
coming for treatment for more than 6 months, 54 people (65.1%) were given
conservative management. Conclusion. There’s a correlation between age,
diabetes mellitus history, LDL, trigliseride, and heart disease history with ischemic
stroke fenomena. Based on the description of patient cases, the incidence of knee
osteoarthritis is more experienced by the age group of 55-64 years, female and not
working (housewives, retirees). Based on the risk factors, the incidence of knee OA
was more common in patients without a history of trauma, BMI 25-29.9 (obesity I),
grade 4 classification, duration of complaints of more than 6 months, and more
patients were managed conservatively.68 HalamanSkripsi Sarjan
Ekspresi Kolagen Tipe I Paska Pemberian Platelet-Rich Plasma (PRP) pada Total Rupture Tendon Achilles Menggunakan Model Uji Eksperimental pada Tikus Wistar
No full textBackground : Achilles tendon ruptures, particularly complete ruptures, are common injuries that often require surgical intervention. Platelet-Rich Plasma (PRP), with its high concentration of growth factors, has emerged as a promising treatment to accelerate tendon healing.
Objectives : This study aims to evaluate the effect of PRP on the expression of Type I collagen in the healing process of completely ruptured Achilles tendons in Wistar rats.
Methods : A quasi-experimental design was employed using 45 adult male Wistar rats with surgically induced complete Achilles tendon ruptures. The rats were divided into three groups: a control group receiving 0.9% NaCl, and two treatment groups receiving 50 μL and 100 μL of PRP, respectively. PRP was prepared from the rats' blood using centrifugation.
Results : On day 15, significant Type I collagen expression was observed in the 100 μL PRP group (3 samples) and the 50 μL PRP group (2 samples) compared to the NaCl group (0 samples). By day 30, sustained collagen expression was noted in the PRP-treated group, with the 100 μL PRP group showing the most pronounced effect.
Conclusion : PRP significantly enhances Type I collagen expression in the healing Achilles tendon, with higher doses of PRP demonstrating more substantial effects.88 pagesTesis Magiste
Comparison of Posterior Tibial Slope and Outcomes of Pre and Post Total Knee Arthroplasty in Osteoarthritis Genu Patients at H. Adam Malik General Hospital Medan
No full textfairly high prevalence in the world population which is a leading source of disability
for public health. Total Knee Arthroplasty (TKA) has been widely accepted as a
definitive therapy for cases of knee OA that have failed nonoperative therapy.
Posterior Tibial Slope (PTS) is a crucial factor influencing anteroposterior stability,
range of motion, tension on knee ligaments, and the balance of flexion and
extension gaps in knee arthroplasty. There is a potential role for PTS as an indicator
of knee joint recovery and TKA success in osteoarthritis patients.
Objective: Examining the PTS in post-TKA osteoarthritis patients at H. Adam
Malik Hospital, Medan.
Methods: This study used a retrospective cohort approach on OA patients who
underwent TKA surgery at H. Adam Malik General Hospital, Medan in September
2021 – October 2022. All data in this research was taken from the patient's medical
records. In subjects who met the inclusion criteria, visual analog scale (VAS), range
of motion, and PTS were examined before and after the TKA procedure. The data
obtained was analyzed statistically.
Results: There are differences in PTS and pre and post TKA surgical outcomes in
genu osteoarthritis patients at H. Adam Malik General Hospital Medan, with PTS
namely t = 6.872 > t table = 1.689 and p = 0.000 < 0.05, flexion outcome namely t = -
4.794 > t table = 1.689 and p = 0.000 t table
= 1.689 and p = 0.000 t table = 1.689 and p
= 0.000 < 0.05.
Conclusion: After performing TKA in OA patients, there is an improvement in
PTS, flexion outcome, extension, and VAS.92 PagesTesis Magiste
Perbandingan Luaran Fungsi Klinis Pasien yang Diinjeksi Periartikular Cocktail Intraoperasi dengan yang Tidak Diinjeksi pada Pasien Osteoarthritis Lutut Derajat Berat yang Menjalani Operasi Penggantian Sendi Lutut di Medan
No full textIntroduction: Total Knee Arthroplasty(TKA) are often performed in severe osteoarthritis when conservative treatment fail to improve the patient's condition. Post-TKA pain is one of the most commonly reported complications by patients and progressively more severe due to soft tissue damage that causes inflammation and triggers the release of inflammatory mediators. In knee OA surgery, it is important to evaluate postoperative pain and knee function. The optimal approach is possible with local intra-articular or peri-articular injections in combination with analgesics. Early recovery of knee function in patients after total knee arthroplasty has been reported to accelerate mobilization and reduce morbidity.
Methods :This study used a retrospective cohort study design conducted at H. Adam Malik General Hospital, Medan. The total sample includes 48 people with an average age of 64 years. All samples were patients diagnosed with osteoarthritis undergoing unilateral primary total knee arthroplasty. The samples were divided into two groups, a control group and an intervention group which were injected with a periarticular cocktail containing a mixture of ropivacaine HCl 7.5 mg, methylprednisolone 125 mg and saline. Clinical function was assessed in both groups using the Visual Analogue Scale (VAS) 12,24,48,72 hour post operative, Oxford Knee Score (OKS) 28 day post operative, Knee joint range of motion (ROM) 1,2,3 and 21 day post operative and Hollander Wound Evaluation Score (HWES).
Results :The mean value of VAS in the control and intervention groups were 3.63 ± 0.57 and 0.5 ± 0.51 at 12 hours postoperatively; 3.63 ± 0.49 and 0.67 ± 0.48 at 24 hours postoperatively; 2.71 ± 0.85 and 1.17 ± 0.48 at 48 hours postoperatively; 2,71±0,55 and 1,17±0,48 at 72 hours postoperatively. The mean ROM values in the control and intervention groups were 10 ± 9.1 and 38.25 ± 10.16 on 1st postoperative day; 41.79 ± 10.77 and 62.83 ± 7.19 on 2nd postoperative days; 80.46 ± 9.93 and 83.54 ± 9.80 at 3rd postoperative days; 106,21±12,9 and 115,88±5,310 at 21st postoperative days. The OKS values on the 28th postoperative day were 34.33 ± 4.22 and 34.92 ± 4.10 in the control and intervention groups. The HWES Score values on 4 week post operation were 5,88±0,35 and 5,92±0,28.
Discussion :In this study, postoperative pain scales (VAS) were significantly reduced (p<0.001) at 12, 24,and 48 hours post operative in the group receiving cocktail injections compared to the control group, indicating that the first 2-day postoperative range of motion (ROM) grade. This demonstrates that the use of periarticular cocktail injections in total knee arthroplasty (TKA) surgery has a positive impact on early mobilization in patients after TKA surgery.76 HalamanTesis Magiste
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